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General NPI Number Information
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NPI Number | 1063608131
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Entity Type | Organization
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Legal Business Name | WILLIAM W. DANIELS, JR., M.D., PC
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Dates
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Enumeration Date | 09/21/2007
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Last Update Date | 09/21/2007
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Provider Practice Location Address
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Address Line | 2927 DEMERE RD
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City | ST SIMONS ISLAND
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State | GA
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Zip | 31522-1620
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Country | US
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Telephone | 912-634-1050
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Fax | 912-634-9111
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Provider Business Mailing Address
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Address Line | PO BOX 3110
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City | BRUNSWICK
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State | GA
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Zip | 31521-3110
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Country | US
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Telephone | 912-634-1050
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Fax | 912-634-9111
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Authorized Official
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Title or Position | PSYCHIATRIST
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Name | DR. WILLIAM WARD DANIELS JR.
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Credential | M.D.
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Telephone | 912-634-1050
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 052551
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License Number State | GA
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